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�4 <br />r <br />P, <br />11 <br />;A <br />t <br />05!30/2003 11:37 FAX 14024714429 NEBRASKA UCC <br />20030'7049 <br />109 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 M(c) Notice of FederA Tax Lien <br />(Rev. October 2000) <br />Area: Serial Number For Optional Use <br />SMALL BUSINESS /SELF EMPLOYED AREA 49 <br />Lien Unit Phone: (8o0) 829 -3903 390370786 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following -named taxpayer. We have made <br />a demand for payment of this liability, but it remahis unpaid. Therefore, <br />there is a Nan in favor of the United States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer GARY D & LYNDA K STATLER <br />1a003/003 <br />Residence 164 LYNN LN <br />GRAND ISLAND, NE 68801 <br />=6325(a). LEASE INFORMATION: For each assessment listed below, <br />lien is refiled by the date given in column (e), this notice shall, <br />ing such date, operate as a certificate of release as defined <br />Tax Period Date of Last Day for <br />IGnd of Tax Ending Identifying Number Assessment Refilling <br />(a b (c ) (d e <br />1040 12/31/1998 505 -44 -4814 04/16/2001 05/16/2011 <br />Place of Filing <br />Register of Deeds Total $ <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />Unpaid Balance <br />of Assessment <br />(f) <br />5018.18 <br />5018.18 <br />This notice was prepared and signed at MILWAUKEE, WZ , on this, <br />26th May 2003 (� <br />the day of �' <br />Signat ACS <br />27- o0 -000B <br />fo &ALGI;ER (800) 829 -3903 <br />(NOTE: Certificate of officer authorized by law to take ecknomedgment is not essential to the validity of Notice of Federal Tax lien <br />D— a„r 71.aRF '/471 - 2 C.B. 4D9) Form 666(Y)(c) (Rev. 10 -00� <br />I <br />